How to prevent post instrumentation pain

1. How to prevent post
instrumentation pain??
Dr.Lena Ali

2. The answer is to follow the biological
objectives of root canal cleaning and shaping
1. Limit the instrumentation to within the root canal.
2. Don’t force necrotic material beyond the foramen.
3. Remove all tissue debris.
4. Complete the cleaning and shaping of individual canals in
a single visit.
5. During the enlargement of the canals, create a space
sufficient to contain any exudate that may form.

3. 1. Limit the instrumentation to within the root canal.

4. Endodontic drainage for an acute alveolar
abscess

5. Apical patency

6. 2. Remove all tissue debris.(Kronfeld’s Mountain
pass)

9. 3. Don’t force necrotic material beyond the
foramen.

12. 4. Complete the cleaning and shaping of individual
canals in a single visit.

13. 5.During the enlargement of the canals, create a space
sufficient to contain any exudate that may form.

14. The treatment
 Recheck the W.L.
 Recheck the patency or perform new recapitulation.
 Eliminate the previously used irritating intra canal
medicament.
 Perform elongated irrigation by sodium hypochlorite as
it’s due to it’s hypertonicity will osmotically extract the
fluids from inflamed tissue.
 Relieve the tooth from occlusion slightly in some
situations.
 Leave the tooth open in some cases (avoid it whenever
possible).